Factors associated with shock in children with dengue hemorrhagic fever
Keywords:
dengue hemorrhagic fever, shock, associated factors
Abstract
Background Shock in dengue hemorrhagic fever (DHF) still con-stitutes an important problem in children. Predicting DHF patients
who will develop shock is difficult.
Objective The aim of this study was to find out factors associated
with shock in DHF.
Methods This was a prospective observational study. Subjects
were children hospitalized from April to July 2000 who met the
WHO criteria for DHF and had positive serological confirmation.
Association between independent variables (age, gender, dura-
tion of fever, abdominal pain, vomiting, hepatomegaly, platelet
count, hematocrit level, and nutritional status) and the dependent
variable (shock) was analyzed by logistic regression model..
Results There were 85 children who met the eligibility criteria
consisting of 50 (59%) boys and 35 (41%) girls with an average
age of 7.1 years (SD 2.88). Shock occurred in 42 (49%) children.
Of the 42 children with shock, the age group of 5-9 years made
up the biggest group (57%) consisting of 23 (55%) boys and 19
(45%) girls. Hepatomegaly was found in 32 (76%) children, ab-
dominal pain and vomiting in 30 (71%) and 36 (86%) children,
respectively, and good nutrition in 22 (52%) children. Shock oc-
curred mainly on the fourth and fifth days (76%). Almost half of
the patients (45% and 52%) had hematocrit level of 46-50% and
platelet count of 20,000-50,000/ml, respectively. By logistic re-
gression analysis, it was found that duration of fever, abdominal
pain, hematocrit level, and platelet count constituted indepen-
dent factors correlating with shock in DHF.
Conclusion Abdominal pain, fever lasting four to five days, hema-
tocrit level of >46%, and platelet count of <50,000/μl were associ-
ated with shock in DHF
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di RSU Manado. Maj Kedokter Indon 1986;6:300-5.
3. Hadinegoro SRS. Telaah endotoksemia pada perjalanan
penyakit demam berdarah dengue: perhatian khusus
pada syok, produksi TNF-α, interleukin 6 sebagai faktor
prediktor demam berdarah dengue berat [dissertation].
Jakarta: Universitas Indonesia; 1996.
4. Sutjipto. Epidemiologi demam berdarah dengue.
Departemen Kesehatan Sulawesi Utara. Presented at the
Simposium Demam Berdarah Dengue; 2000 Feb;
Manado, Indonesia.
5. Wantania JM, Wahani A, Opit C, Mulyono R,
Wijayanto T, Muljanto S, et al, editors. Gambaran
kasus demam berdarah di Bagian Anak RSUP
Malalayang Manado. Presented at the Simposium
Demam Berdarah Dengue; 2000 Feb; Manado, In-
donesia.
6. Cohen SN, Halstead SB. Shock associated with den-
gue infection. Trop Ped 1966;3:448-56.
7. World Health Organization. Dengue haemorrhagic
fever: diagnosis, treatment, prevention and control. 2 nd
ed. WHO: Geneva; 1997.
8. Darmowandowo W. Correlation between humoral im-
mune response and the severity of dengue hemorrhagic
fever. In: Kuntaman, Lusida MI, Hargono R, Poernomo
B, editors. Proceedings of the International Seminar
on Dengue Fever/Dengue Hemorrhagic Fever; 1999
Oct 28-29; Surabaya, Indonesia.
9. Soegiyanto S, Darmowandowo W, Basuki PS. Transmis-
sion dynamic of dengue hemorrhagic fever in Sawahan
Surabaya Indonesia. In: Kuntaman, Lusida MI, Hargono
R, Poernomo B, editors. Proceedings of the International
Seminar on Dengue Fever /Dengue Hemorrhagic Fe-
ver; 1999 Oct 28-29; Surabaya, Indonesia.
10. Lum LCS, Goh AYT, Chan PWK. Determinants of
outcome in severe dengue hemorrhagic fever. In:
Kuntaman, Lusida MI, Hargono R, Poernomo B, edi-
tors. Proceedings of the International Seminar on Den-
gue Fever/Dengue Hemorrhagic Fever; 1999 Oct 28-
29; Surabaya, Indonesia.
11. Prawirosudarmo S. Masalah demam berdarah dengue di
Indonesia. Presented at Pelatihan Demam Berdarah Den-
gue Tingkat Nasional; 1998 Nov; Jakarta, Indonesia.
12. Halstead SB. Epidemiology of dengue and dengue hem-
orrhagic fever. In: Gubler DJ, Kuno G, editors. Dengue
and dengue hemorrhagic fever. New york: CAB Inter-
national; 1997. p. 23-44.
13. Hadinegoro SRH, Soegijanto S, Wuryadi S, Suroso T.
Tatalaksana demam dengue/demam berdarah dengue.
Jakarta: Departemen Kesehatan RI; 1999.
14. Soe T, Aung MM, Shwe NT. Risk factors in dengue shock
syndrome. Am J Trop Med Hyg 1997;56:566-72.
15. Gubler DJ. Dengue and dengue hemorrhagic fever. Clin
Microbiol Rev 1998;11:1-14.
16. Bhamarapravati N. Pathology of dengue infection. In: Gubler
DJ, Kuno G, editors. Dengue and dengue hemorrhagic fe-
ver. New york: CAB International; 1997. p. 115-32.
17. Sumarmo. Demam berdarah dengue pada anak. Jakarta:
UI Press; 1983.
18. Nimmannitya S. Clinical management of dengue
haemorrhagic fever/dengue shock syndrome. WHO
Dengue Bulletin 1996;20:13-9.
19. Sutaryo. Patogenesis dan patofisiologi demam berdarah
dengue. Cerm Dunia Kedokter edisi khusus 1992; 81:35-8.
Published
2016-10-10
How to Cite
1.
Kan E, Rampengan T. Factors associated with shock in children with dengue hemorrhagic fever. PI [Internet]. 10Oct.2016 [cited 26Apr.2024];44(5):171-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/758
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Received 2016-10-02
Accepted 2016-10-02
Published 2016-10-10
Accepted 2016-10-02
Published 2016-10-10
